Ellen D Gould, RDH

Individual provider Active NPI Dental Hygienist · Brewster, MA

NPI 1578878591 · NPPES record last updated Aug 13, 2010

Key facts

NPI
1578878591
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
5762 (MA)
Practice address
103 Lake Shore Dr
Brewster, MA 02631-2429
Phone
(877) 654-7878
NPI assigned
Aug 13, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 5762 MA Yes

Addresses

Primary practice location

103 Lake Shore Dr
Brewster, MA 02631-2429

Mailing address

PO Box 990284
Boston, MA 02199-0284
Phone (508) 237-5378

Other providers in Brewster, MA

All providers in Brewster, MA · Dental Hygienist in Massachusetts

Sources for this page

Verify at the official NPI Registry.